1. Field of the Invention
The teachings provided herein generally relate to a device and a method for performing a hip surgery that includes posterior retraction of soft tissue.
2. Description of the Related Art
More than 249,000 hip replacement surgeries are performed each year in the United States. Traditionally, hip surgeries required large incisions ranging from about 6 inches to about 12 inches in length, depending on the size of the patient and whether the surgery is a hip revision or a total hip arthroplasty, The larger the incision, the more risk there is to a number of important stabilizing muscles and tendons, potentially introducing further damage to the hip joint and surrounding soft tissue. Larger incisions also lead to larger blood losses, longer rehabilitation times, and larger scars. Minimally invasive surgery is now used and can reduce the incision to 3-5 inches. A patient can experience a faster recovery, and the hospital stay can often be reduced substantially, significantly lowering the cost of the hospital fees.
The instruments used in minimally invasive surgery should provide a surgeon with the ability to precisely locate the implant without complications, such as dislocation or subluxation, and should allow the surgeon to work within the relatively limited space of the smaller incision. The posterior retractor is commonly used in hip surgeries, such as the poster-inferior retractors available from Innomed, Inc., Savannah, Ga., 31404. See also, U.S. Pat. No. 6,855,149.
During a hip arthroplasty, the tissues posterior to the acetabulum are retracted, that is, pulled back away from the acetabulum using a standard “posterior retractor” to prepare the acetabulum for the insertion of a prosthesis. Problems associated with the use of currently available posterior retractors include the inability to reliably anchor the retractor and apply a stable leverage in the amount necessary to pull back the tissues. Currently available posterior retractors rely on a projection of bone (the “posterior lip”) posterior to the acetabulum to anchor the retractor and provide this leverage. Unfortunately, in patients with bone disorders such as arthritis or osteoporosis, the posterior lip often does not provide optimal leverage or stability, given the deformation and corrosion of the affected area.
A reliable anchoring and stable leverage system would allow for more effective retraction of soft tissue, avoidance of the sciatic nerve, and optimal visualization of the acetabulum. Furthermore, currently available posterior retractors are used for only the left hip or the right hip. Accordingly, practitioners would appreciate a posterior retractor that provides reliable anchoring to the pelvic bone and the associated benefits of having stable leverage. Such an instrument would provide an effective and stable retracing of the posterior muscles surrounding the acetabulum, provide an adequate clearance in and around the surgical area, be useful in the arthroplasty of hips having common acetabular diameters, and be a simple and reliable device made from an FDA approved material that can be easily cleaned and sterilized. Moreover, an instrument having a design that could be used equally well with either the right or left hip would also add substantially to the appeal of the tool, reducing the need for multiple tools.